Cholesterol and central serotoninergic activity in parasuicide and depression

Background and aims. A reduced PRL and cortisol response after d- fenfluramine and therefore reduced serotoninergic tone have been reported in depressed and/or parasuicide patients. A correlation between reduced cholesterolemia and suicidal behavior has also emerged over the past years, prompting some authors to hypothesize that this alteration underlies the reduced serotoninergic transmission in these patients. The aim of this study was to analyze the correlation between cholesterol and central serotonergic activity in parasuicide depression. Methods. A total of 18 subjects took part in the study: 12 patients (8 females and 4 males, mean age 44.6±15.4) and 6 controls (4 females and 2 males, mean age 39.1±9.5). The d-fenfluramine test was performed within 24 hours of attempted suicide and a blood sample was taken to evaluate hematochemical parameters. Results. Total plasma cholesterol (159.3±26.8 mg/dl vs 239.7±20.4 mg/dl, p<0.001) and HDLC (46.2±5.0 mg/dl vs 84.5±16.3 mg/dl, p<0.01) were lower in patients who had attempted suicide. Peak levels of prolactin and cortisol after d-fenfluramine did not appear to be correlated with total cholesterol or its fractions, or to triglycerides, but appeared to be correlated with the severity of depressive symptoms. Conclusions. In conclusions, alterations in the lipid metabolism appeared to be correlated to the idea of suicide and weight loss, whereas reduced serotoninergic tone appeared to be correlated more to the severity of depression and agitation in the group of patients studied.